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Two Questions May Rule Out Strep Throat

Researchers say home test could determine when a sore throat doesn't warrant a trip to the doctor

WebMD News from HealthDay

By Brenda Goodman

HealthDay Reporter

MONDAY, Nov. 4 (HealthDay News) -- Your throat is on fire. It hurts to swallow, and you're losing your voice. Is it time to see a doctor for antibiotics?

In the near future, researchers report, it may be possible to click on an app, answer two questions about your symptoms and find out whether a seriously sore throat is actually a strep infection.

"Those questions would be: Do you have a cough, and have you had a fever in the last 24 hours?" said study author Dr. Andrew Fine, a pediatric emergency medicine specialist at Boston Children's Hospital. High fevers are a hallmark of strep infections, while coughs are not.

In a new study of more than 70,000 patients with sore throats, those two questions and an accounting of how common strep infections were within a local area ruled out cases of strep throat nearly as well as lab tests did.

"This enables us to use the test of time," said co-study author Dr. Kenneth Mandl, a professor of bioinformatics at Harvard. "If we determine that you're low risk and most cases will not have an important complication from strep anyway, then you can be followed clinically rather than come in for a test right away, and you may improve."

The researchers think that if the new test was widely used, it could save hundreds of thousands of unnecessary trips to the doctor each year and cut down on the overprescribing of antibiotics.

The study will be published Nov. 5 in the Annals of Internal Medicine.

The question of what to do for adults who have bad sore throats is a tough one, even for doctors.

About 15 million Americans see a doctor for a sore throat each year, and 70 percent of them get antibiotics to treat it, according to the Infectious Diseases Society of America. That's far more than the 20 percent to 30 percent of children and 5 percent to 15 percent of adults who actually benefit from taking the powerful drugs.

The problem is that most sore throats are caused by viruses, not bacteria, so antibiotics don't help clear up the infection. Taking antibiotics when they aren't needed can cause severe diarrhea and it contributes to the problem of antibiotic resistance -- when bacteria can no longer be killed by the drugs that are available to fight them off.

But cases of strep throat, which is caused by bacteria, can be more dangerous.

"There are both medical, as well as considerable public health, reasons that we are concerned about strep throat," said Dr. Edward Kaplan. A pediatric infectious disease specialist at the University of Minnesota, in Minneapolis, Kaplan wrote an editorial that accompanied the study.

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